Active NPI
Samuel Davis
- Developmental Therapist
- Kissimmee, FL
National Provider Identifier
1740576164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- Practice address
- 1200 N Central Ave Ste 212
Kissimmee, FL 34741-4440 - Phone
- (407) 259-8438
- NPI assigned
- Jun 23, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Primary |
Addresses
Primary practice location
1200 N Central Ave Ste 212
Kissimmee, FL 34741-4440
Mailing address
3327 Jujube Dr
Orlando, FL 32810-2980
Phone (407) 927-9810
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308787200000",
"number": "1740576164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3327 JUJUBE DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328102980",
"telephone_number": "407-927-9810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 N CENTRAL AVE STE 212",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347414440",
"telephone_number": "407-259-8438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "SAMUEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-23",
"last_updated": "2011-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.